Benchmark of Segmentation Techniques for Pelvic Fracture in CT and X-ray: Summary of the PENGWIN 2024 Challenge

The segmentation of pelvic fracture fragments in CT and X-ray images is crucial for trauma diagnosis, surgical planning, and intraoperative guidance. However, accurately and efficiently delineating the bone fragments remains a significant challenge due to complex anatomy and imaging limitations. The PENGWIN challenge, organized as a MICCAI 2024 satellite event, aimed to advance automated fracture segmentation by benchmarking state-of-the-art algorithms on these complex tasks. A diverse dataset of 150 CT scans was collected from multiple clinical centers, and a large set of simulated X-ray images was generated using the DeepDRR method. Final submissions from 16 teams worldwide were evaluated under a rigorous multi-metric testing scheme. The top-performing CT algorithm achieved an average fragment-wise intersection over union (IoU) of 0.930, demonstrating satisfactory accuracy. However, in the X-ray task, the best algorithm attained an IoU of 0.774, highlighting the greater challenges posed by overlapping anatomical structures. Beyond the quantitative evaluation, the challenge revealed methodological diversity in algorithm design. Variations in instance representation, such as primary-secondary classification versus boundary-core separation, led to differing segmentation strategies. Despite promising results, the challenge also exposed inherent uncertainties in fragment definition, particularly in cases of incomplete fractures. These findings suggest that interactive segmentation approaches, integrating human decision-making with task-relevant information, may be essential for improving model reliability and clinical applicability.

Landmarks Are Alike Yet Distinct: Harnessing Similarity and Individuality for One-Shot Medical Landmark Detection

Landmark detection plays a crucial role in medical imaging applications such as disease diagnosis, bone age estimation, and therapy planning. However, training models for detecting multiple landmarks simultaneously often encounters the "seesaw phenomenon", where improvements in detecting certain landmarks lead to declines in detecting others. Yet, training a separate model for each landmark increases memory usage and computational overhead. To address these challenges, we propose a novel approach based on the belief that "landmarks are distinct" by training models with pseudo-labels and template data updated continuously during the training process, where each model is dedicated to detecting a single landmark to achieve high accuracy. Furthermore, grounded on the belief that "landmarks are also alike", we introduce an adapter-based fusion model, combining shared weights with landmark-specific weights, to efficiently share model parameters while allowing flexible adaptation to individual landmarks. This approach not only significantly reduces memory and computational resource requirements but also effectively mitigates the seesaw phenomenon in multi-landmark training. Experimental results on publicly available medical image datasets demonstrate that the single-landmark models significantly outperform traditional multi-point joint training models in detecting individual landmarks. Although our adapter-based fusion model shows slightly lower performance compared to the combined results of all single-landmark models, it still surpasses the current state-of-the-art methods while achieving a notable improvement in resource efficiency.

SDD-4DGS: Static-Dynamic Aware Decoupling in Gaussian Splatting for 4D Scene Reconstruction

Dynamic and static components in scenes often exhibit distinct properties, yet most 4D reconstruction methods treat them indiscriminately, leading to suboptimal performance in both cases. This work introduces SDD-4DGS, the first framework for static-dynamic decoupled 4D scene reconstruction based on Gaussian Splatting. Our approach is built upon a novel probabilistic dynamic perception coefficient that is naturally integrated into the Gaussian reconstruction pipeline, enabling adaptive separation of static and dynamic components. With carefully designed implementation strategies to realize this theoretical framework, our method effectively facilitates explicit learning of motion patterns for dynamic elements while maintaining geometric stability for static structures. Extensive experiments on five benchmark datasets demonstrate that SDD-4DGS consistently outperforms state-of-the-art methods in reconstruction fidelity, with enhanced detail restoration for static structures and precise modeling of dynamic motions. The code will be released.

AA-CLIP: Enhancing Zero-shot Anomaly Detection via Anomaly-Aware CLIP

Anomaly detection (AD) identifies outliers for applications like defect and lesion detection. While CLIP shows promise for zero-shot AD tasks due to its strong generalization capabilities, its inherent Anomaly-Unawareness leads to limited discrimination between normal and abnormal features. To address this problem, we propose Anomaly-Aware CLIP (AA-CLIP), which enhances CLIP's anomaly discrimination ability in both text and visual spaces while preserving its generalization capability. AA-CLIP is achieved through a straightforward yet effective two-stage approach: it first creates anomaly-aware text anchors to differentiate normal and abnormal semantics clearly, then aligns patch-level visual features with these anchors for precise anomaly localization. This two-stage strategy, with the help of residual adapters, gradually adapts CLIP in a controlled manner, achieving effective AD while maintaining CLIP's class knowledge. Extensive experiments validate AA-CLIP as a resource-efficient solution for zero-shot AD tasks, achieving state-of-the-art results in industrial and medical applications. The code is available at https://github.com/Mwxinnn/AA-CLIP.

Hi-End-MAE: Hierarchical encoder-driven masked autoencoders are stronger vision learners for medical image segmentation

Medical image segmentation remains a formidable challenge due to the label scarcity. Pre-training Vision Transformer (ViT) through masked image modeling (MIM) on large-scale unlabeled medical datasets presents a promising solution, providing both computational efficiency and model generalization for various downstream tasks. However, current ViT-based MIM pre-training frameworks predominantly emphasize local aggregation representations in output layers and fail to exploit the rich representations across different ViT layers that better capture fine-grained semantic information needed for more precise medical downstream tasks. To fill the above gap, we hereby present Hierarchical Encoder-driven MAE (Hi-End-MAE), a simple yet effective ViT-based pre-training solution, which centers on two key innovations: (1) Encoder-driven reconstruction, which encourages the encoder to learn more informative features to guide the reconstruction of masked patches; and (2) Hierarchical dense decoding, which implements a hierarchical decoding structure to capture rich representations across different layers. We pre-train Hi-End-MAE on a large-scale dataset of 10K CT scans and evaluated its performance across seven public medical image segmentation benchmarks. Extensive experiments demonstrate that Hi-End-MAE achieves superior transfer learning capabilities across various downstream tasks, revealing the potential of ViT in medical imaging applications. The code is available at: https://github.com/FengheTan9/Hi-End-MAE

Towards Accurate Unified Anomaly Segmentation

Unsupervised anomaly detection (UAD) from images strives to model normal data distributions, creating discriminative representations to distinguish and precisely localize anomalies. Despite recent advancements in the efficient and unified one-for-all scheme, challenges persist in accurately segmenting anomalies for further monitoring. Moreover, this problem is obscured by the widely-used AUROC metric under imbalanced UAD settings. This motivates us to emphasize the significance of precise segmentation of anomaly pixels using pAP and DSC as metrics. To address the unsolved segmentation task, we introduce the Unified Anomaly Segmentation (UniAS). UniAS presents a multi-level hybrid pipeline that progressively enhances normal information from coarse to fine, incorporating a novel multi-granularity gated CNN (MGG-CNN) into Transformer layers to explicitly aggregate local details from different granularities. UniAS achieves state-of-the-art anomaly segmentation performance, attaining 65.12/59.33 and 40.06/32.50 in pAP/DSC on the MVTec-AD and VisA datasets, respectively, surpassing previous methods significantly. The codes are shared at https://github.com/Mwxinnn/UniAS.

Bridged Semantic Alignment for Zero-shot 3D Medical Image Diagnosis

3D medical images such as Computed tomography (CT) are widely used in clinical practice, offering a great potential for automatic diagnosis. Supervised learning-based approaches have achieved significant progress but rely heavily on extensive manual annotations, limited by the availability of training data and the diversity of abnormality types. Vision-language alignment (VLA) offers a promising alternative by enabling zero-shot learning without additional annotations. However, we empirically discover that the visual and textural embeddings after alignment endeavors from existing VLA methods form two well-separated clusters, presenting a wide gap to be bridged. To bridge this gap, we propose a Bridged Semantic Alignment (BrgSA) framework. First, we utilize a large language model to perform semantic summarization of reports, extracting high-level semantic information. Second, we design a Cross-Modal Knowledge Interaction (CMKI) module that leverages a cross-modal knowledge bank as a semantic bridge, facilitating interaction between the two modalities, narrowing the gap, and improving their alignment. To comprehensively evaluate our method, we construct a benchmark dataset that includes 15 underrepresented abnormalities as well as utilize two existing benchmark datasets. Experimental results demonstrate that BrgSA achieves state-of-the-art performances on both public benchmark datasets and our custom-labeled dataset, with significant improvements in zero-shot diagnosis of underrepresented abnormalities.

HYATT-Net is Grand: A Hybrid Attention Network for Performant Anatomical Landmark Detection

Anatomical landmark detection (ALD) from a medical image is crucial for a wide array of clinical applications. While existing methods achieve quite some success in ALD, they often struggle to balance global context with computational efficiency, particularly with high-resolution images, thereby leading to the rise of a natural question: where is the performance limit of ALD? In this paper, we aim to forge performant ALD by proposing a {\bf HY}brid {\bf ATT}ention {\bf Net}work (HYATT-Net) with the following designs: (i) A novel hybrid architecture that integrates CNNs and Transformers. Its core is the BiFormer module, utilizing Bi-Level Routing Attention for efficient attention to relevant image regions. This, combined with Attention Residual Module(ARM), enables precise local feature refinement guided by the global context. (ii) A Feature Fusion Correction Module that aggregates multi-scale features and thus mitigates a resolution loss. Deep supervision with a mean-square error loss on multi-resolution heatmaps optimizes the model. Experiments on five diverse datasets demonstrate state-of-the-art performance, surpassing existing methods in accuracy, robustness, and efficiency. The HYATT-Net provides a promising solution for accurate and efficient ALD in complex medical images. Our codes and data are already released at: \url{https://github.com/ECNUACRush/HYATT-Net}.

Hybrid Attention Network: An efficient approach for anatomy-free landmark detection

Accurate anatomical landmark detection in medical images is crucial for clinical applications. Existing methods often struggle to balance global context with computational efficiency, particularly with high-resolution images. This paper introduces the Hybrid Attention Network(HAN), a novel hybrid architecture integrating CNNs and Transformers. Its core is the BiFormer module, utilizing Bi-Level Routing Attention (BRA) for efficient attention to relevant image regions. This, combined with Convolutional Attention Blocks (CAB) enhanced by CBAM, enables precise local feature refinement guided by the global context. A Feature Fusion Correction Module (FFCM) integrates multi-scale features, mitigating resolution loss. Deep supervision with MSE loss on multi-resolution heatmaps optimizes the model. Experiments on five diverse datasets demonstrate state-of-the-art performance, surpassing existing methods in accuracy, robustness, and efficiency. The HAN provides a promising solution for accurate and efficient anatomical landmark detection in complex medical images. Our codes and data will be released soon at: \url{https://github.com/MIRACLE-Center/}.

MS-Glance: Non-semantic context vectors and the applications in supervising image reconstruction

Non-semantic context information is crucial for visual recognition, as the human visual perception system first uses global statistics to process scenes rapidly before identifying specific objects. However, while semantic information is increasingly incorporated into computer vision tasks such as image reconstruction, non-semantic information, such as global spatial structures, is often overlooked. To bridge the gap, we propose a biologically informed non-semantic context descriptor, \textbf{MS-Glance}, along with the Glance Index Measure for comparing two images. A Global Glance vector is formulated by randomly retrieving pixels based on a perception-driven rule from an image to form a vector representing non-semantic global context, while a local Glance vector is a flattened local image window, mimicking a zoom-in observation. The Glance Index is defined as the inner product of two standardized sets of Glance vectors. We evaluate the effectiveness of incorporating Glance supervision in two reconstruction tasks: image fitting with implicit neural representation (INR) and undersampled MRI reconstruction. Extensive experimental results show that MS-Glance outperforms existing image restoration losses across both natural and medical images. The code is available at \url{https://github.com/Z7Gao/MSGlance}.